Urinary incontinence can affect confidence, comfort and everyday life, but it is far more common than many people realise, particularly following prostate surgery, with an enlarged prostate, or as part of ageing and changes in bladder health.

For men experiencing symptoms such as leakage, urgency, poor bladder control or changes in the flow of urine, understanding the cause is the first step towards finding the right support.

Professor Francis Chinegwundoh MBE, Consultant Urological Surgeon, provides experienced, compassionate guidance to help patients better understand their type of incontinence and the most appropriate treatment options available.

How the Bladder Works

The urinary bladder stores urine which is continuously excreted by the kidneys. When the bladder is full the urinary sphincter muscles along the length of the urethra (the tube leading from the bladder) relax and the bladder contracts and empties. Once the bladder is empty, the bladder muscle relaxes and the urethral sphincter closes again.

Cause of Incontinence in Men and Women

Urinary incontinence affects up to 15% of women and increases with age. Incontinence occurs when the sphincter muscle does not close properly or the bladder contracts when it should not.

Inadequate closure of the sphincter may follow damage to the muscles and nerves of the pelvic floor after vaginal delivery. This may be aggravated by the menopause, a chronic cough or heavy physical activity. The patient usually complains of urine loss on coughing or exertion which is called stress incontinence.

Overactive bladder occurs when the bladder muscle contracts when it should be storing urine, leading to urgency and urge incontinence. This may be due to injury to the bladder’s nerve supply or to a psychosomatic cause associated with anxiety. Occasionally both incompetence of the sphincter and bladder over-activity co-exist.

Incontinence is not a fatal condition but it can significantly interfere with professional, social, and personal activities with deterioration in the quality of life and sometimes social isolation. It is, therefore, important and worthwhile to have treatment.

Understanding the Different Types of Urinary Incontinence

There are several forms of urinary incontinence, including stress incontinence, urge incontinence, overflow incontinence and functional incontinence. Each affects the bladder and urethra differently, which is why careful assessment matters.

For some, lifestyle changes such as bladder training, maintaining a healthy weight and pelvic floor exercises may significantly improve symptoms.

For others, further support may involve specialist investigations, targeted therapies or carefully considered stress incontinence operations. The most effective approach depends on the underlying cause, severity of symptoms and how much incontinence is affecting daily life, with the aim of improving comfort, confidence and long-term bladder control.

Curing Incontinence and Treatment Options

There are many different kinds of treatment for female incontinence depending on the cause. Firstly it is important to make sure that there isn’t a urine infection (cystitis) as this can sometimes cause temporary incontinence and is easily treated.

If the main complaint is stress incontinence, pelvic floor exercises may be helpful. These have to be practised daily and a cure rate of up to 70% may be expected.

If these fail or are inappropriate, surgery is the next step. Conventional major surgery may achieve a success rate of 85% to 90% but there is usually a 4-6 day stay in hospital and some discomfort from the abdominal wound with an eventual return to work after 4 to 6 weeks.

An alternative approach is to inject bulking agents around the bladder neck (where the urethra leaves the bladder) to prevent it opening too easily. This procedure may achieve up to 70% success but re-injection may be required.

TVT (Tension-Free Vaginal Tape)

A technique has been devised which overcomes the modest success rate of pelvic floor muscle exercises and avoids the pain and long hospital stay of more major operations.

This procedure achieves between 85% to 90% success and has little post-operative pain so the patient leaves the hospital either on the same day or on the following day.

It works by supporting the middle of the urethra.

Gynecare TVT is an exciting new concept. The mesh consists of a permanent Prolene material surrounded by a plastic sheath with a strong needle at either end. A small cut is made in the vagina and the mesh is passed under the middle of the urethra to support it. Both needles emerge through the anterior abdominal wall so that the mesh is accurately positioned.

Stress Incontinence Procedures

A fine telescope (cystoscope) is introduced into the bladder to be absolutely sure there is no bladder injury, and then the position is adjusted and needles are removed.

The vaginal and abdominal wounds are then closed and the patient returns to the ward. The operation takes up to 30 minutes. Some pain relief may be necessary and the patient usually passes urine within a few hours and can return home either the same day or the following day.

Success Rates and Complications

Complications of surgery for stress incontinence can include bleeding or bladder injury when the needles are passed, difficulty emptying the bladder, urgency and urinary infection. So far there have been no significant long-term side effects.

Treatment for Male Incontinence Questions & Answers

Support for Restoring Confidence with Urinary Incontinence

Living with urinary incontinence can feel frustrating or isolating, but effective treatment for male incontinence is available, and no one should feel they simply have to “put up with it.”

From conservative bladder health strategies and lifestyle changes to specialist surgery and procedures, modern care offers a range of solutions tailored to the type of incontinence, severity of symptoms and underlying cause.

Professor Francis Chinegwundoh MBE understands that every patient’s experience is different. Whether symptoms are linked to previous prostate surgery, bladder weakness, or other urological concerns, his approach focuses on clear diagnosis, practical support and helping each individual regain confidence, comfort and better bladder control through personalised treatment.

References

• Ulmsten U, Johnson P & Rezapour M. 1999. A 3 year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Brit. J. Obstet Gynaecol; 106:345-350.
• Olsson, Kroon 1999. A 3 year postoperative evaluation of tension free vaginal tape. Gynecol. Ostet. Invest;48:267-269.

More Information

You can find additional resources at:

• NHS Urinary Incontinence
• The Bladder and Bowel Community

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Whether you’re ready to make an appointment or simply have questions, we’re here to help. Call +44 (0) 7746 299 121, email mail@urologyconsultant.co.uk or use the contact form.